Low serum magnesium and 1-year mortality in alcohol withdrawal syndrome.
Adult
Age Factors
Aged
Aged, 80 and over
Alanine Transaminase
/ blood
Alkaline Phosphatase
/ blood
Aspartate Aminotransferases
/ blood
Benzodiazepines
/ therapeutic use
Bilirubin
/ blood
C-Reactive Protein
/ metabolism
Central Nervous System Depressants
/ adverse effects
Ethanol
/ adverse effects
Female
Humans
Logistic Models
Magnesium
/ blood
Magnesium Deficiency
/ blood
Male
Middle Aged
Mortality
Multivariate Analysis
Platelet Count
Prognosis
Proton Pump Inhibitors
/ therapeutic use
Retrospective Studies
Risk Factors
Scotland
/ epidemiology
Serum Albumin
/ metabolism
Severity of Illness Index
Sodium
/ blood
Substance Withdrawal Syndrome
/ blood
Young Adult
Journal
European journal of clinical investigation
ISSN: 1365-2362
Titre abrégé: Eur J Clin Invest
Pays: England
ID NLM: 0245331
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
06
12
2018
revised:
31
05
2019
accepted:
17
06
2019
pubmed:
20
6
2019
medline:
2
6
2020
entrez:
20
6
2019
Statut:
ppublish
Résumé
In 2014, the WHO reported that 6% of all deaths were attributable to excess alcohol consumption. The aim of the present study was to examine the relationship between serum magnesium concentrations and mortality in patients with alcohol withdrawal syndrome (AWS). A retrospective review of 700 patients with documented evidence of previous AWS indicating a requirement for benzodiazepine prophylaxis or evidence of alcohol withdrawal syndrome between November 2014 and March 2015. Of 380 patients included in the sample analysis, 64 (17%) were dead at 1 year following the time of treatment for AWS. The majority of patients had been prescribed thiamine (77%) and a proton pump inhibitor (66%). In contrast, the majority of patients had low circulating magnesium concentrations (<0.75 mmol/L) (64%) and had not been prescribed magnesium (90%). The median age of death at one year was 55 years (P = 0.002). On univariate analysis, age (P < 0.05), GMAWS (P < 0.05), BDZ (P < 0.05), bilirubin (P < 0.001), alkaline phosphatase (P < 0.001), albumin (P < 0.001), CRP (P < 0.05), AST:ALT ratio >2 (P < 0.001), sodium (P < 0.05), magnesium (P < 0.001), platelets (P < 0.05) and the use of proton pump inhibitor medication (P < 0.001) were associated with death at 1 year. On multivariate binary logistic regression analysis, age > 50 years (OR 3.37, 95% CI 1.52-7.48, P < 0.01), AST:ALT ratio >2 (OR 3.10, 95% CI 1.38-6.94, P < 0.01) and magnesium < 0.75 mmol/L (OR 4.11, 95% CI 1.3-12.8, P < 0.05) remained independently associated with death at 1 year. Overall, 1-year mortality was significantly higher among those patients who were magnesium deficient (<0.75 mmol/L) when compared to those who were replete (≥0.75 mmol/L; P < 0.001).
Sections du résumé
BACKGROUND
BACKGROUND
In 2014, the WHO reported that 6% of all deaths were attributable to excess alcohol consumption. The aim of the present study was to examine the relationship between serum magnesium concentrations and mortality in patients with alcohol withdrawal syndrome (AWS).
MATERIALS AND METHODS
METHODS
A retrospective review of 700 patients with documented evidence of previous AWS indicating a requirement for benzodiazepine prophylaxis or evidence of alcohol withdrawal syndrome between November 2014 and March 2015.
RESULTS
RESULTS
Of 380 patients included in the sample analysis, 64 (17%) were dead at 1 year following the time of treatment for AWS. The majority of patients had been prescribed thiamine (77%) and a proton pump inhibitor (66%). In contrast, the majority of patients had low circulating magnesium concentrations (<0.75 mmol/L) (64%) and had not been prescribed magnesium (90%). The median age of death at one year was 55 years (P = 0.002). On univariate analysis, age (P < 0.05), GMAWS (P < 0.05), BDZ (P < 0.05), bilirubin (P < 0.001), alkaline phosphatase (P < 0.001), albumin (P < 0.001), CRP (P < 0.05), AST:ALT ratio >2 (P < 0.001), sodium (P < 0.05), magnesium (P < 0.001), platelets (P < 0.05) and the use of proton pump inhibitor medication (P < 0.001) were associated with death at 1 year. On multivariate binary logistic regression analysis, age > 50 years (OR 3.37, 95% CI 1.52-7.48, P < 0.01), AST:ALT ratio >2 (OR 3.10, 95% CI 1.38-6.94, P < 0.01) and magnesium < 0.75 mmol/L (OR 4.11, 95% CI 1.3-12.8, P < 0.05) remained independently associated with death at 1 year.
CONCLUSION
CONCLUSIONS
Overall, 1-year mortality was significantly higher among those patients who were magnesium deficient (<0.75 mmol/L) when compared to those who were replete (≥0.75 mmol/L; P < 0.001).
Substances chimiques
Central Nervous System Depressants
0
Proton Pump Inhibitors
0
Serum Albumin
0
Benzodiazepines
12794-10-4
Ethanol
3K9958V90M
C-Reactive Protein
9007-41-4
Sodium
9NEZ333N27
Aspartate Aminotransferases
EC 2.6.1.1
Alanine Transaminase
EC 2.6.1.2
Alkaline Phosphatase
EC 3.1.3.1
Magnesium
I38ZP9992A
Bilirubin
RFM9X3LJ49
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13152Informations de copyright
© 2019 Stichting European Society for Clinical Investigation Journal Foundation.
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